{"id":13057,"date":"2021-03-18T16:03:59","date_gmt":"2021-03-18T16:03:59","guid":{"rendered":"https:\/\/www.medicalbillersandcoders.com\/blog\/?p=13057"},"modified":"2025-09-08T08:37:36","modified_gmt":"2025-09-08T08:37:36","slug":"oncologists-should-be-prepared-for-em-service-changes-in-2021","status":"publish","type":"post","link":"https:\/\/www.medicalbillersandcoders.com\/blog\/oncologists-should-be-prepared-for-em-service-changes-in-2021\/","title":{"rendered":"Oncologists should be prepared for E&#038;M service changes in 2021"},"content":{"rendered":"<p style=\"text-align: left;\">It is important for all oncologists to be prepared as significant changes to the Evaluation and Management (E&amp;M) codes E\/M are into effect from January 1, 2021.<\/p>\n<p style=\"text-align: left;\">Components for code selection were narrowed down to make them more clinically intuitive and to reduce variation among contractors and payers.<\/p>\n<h2 style=\"text-align: left;\"><a href=\"https:\/\/www.ama-assn.org\/practice-management\/cpt\/how-2021-em-coding-changes-will-reshape-physician-note\">Elements of MDM affecting coding<\/a> for an outpatient or office visit include:<\/h2>\n<ul style=\"text-align: left;\">\n<li style=\"text-align: left;\">The number and complexity of problems addressed in the encounter, meaning it will no longer be necessary to document every diagnosis a patient has received\u2014just those being addressed during that visit.<\/li>\n<li style=\"text-align: left;\">The amount or complexity of data to be reviewed and analyzed. This reduces physicians to enter voluminous repetitive test data that is irrelevant or ancillary to the purpose of the visit.<\/li>\n<li style=\"text-align: left;\">Risk of complications or morbidity of patient management. This can now include social determinants of health and reasons behind decisions not to admit a patient or intervene in some way.<\/li>\n<\/ul>\n<p style=\"text-align: left;\">Previously, history and exam are two of the three components used to select the appropriate E&amp;M service. In 2021, history and exam will no longer be used to select an E&amp;M service, but still must be performed in order to report <strong>CPT codes 99202-99215<\/strong>.<\/p>\n<p style=\"text-align: left;\">The changes are in the form of the definition of time, changes to medical decision-making criteria, and the addition of a new prolonged services code to current office and outpatient E&amp;M codes (Current Procedural Terminology [CPT] <strong>codes 99202-99215<\/strong>).<\/p>\n<h2 style=\"text-align: left;\">Definition of time<\/h2>\n<p style=\"text-align: left;\">When it considers the concept of time regarding E&amp;M services <strong>CPT codes 99202-99215<\/strong> are associated with and they have been updated from the typical face-to-face time to total time spent on the day of the encounter.<\/p>\n<p style=\"text-align: left;\">The total time corresponding to <strong>CPT codes 99202-99215<\/strong> has been defined as specific intervals. For example, in order to report <strong>99215<\/strong>, 40-54 minutes of total time must be spent on the date of the encounter. Currently, <strong>99215<\/strong> need typically 40 minutes.<\/p>\n<h3 style=\"text-align: left;\">Codes selected based on time will include the following activities:<\/h3>\n<ul style=\"text-align: left;\">\n<li style=\"text-align: left;\">Preparing to see the patient<\/li>\n<li style=\"text-align: left;\">Seeing the patient<\/li>\n<li style=\"text-align: left;\">Obtaining and\/or reviewing the separately obtained history<\/li>\n<li style=\"text-align: left;\">Ordering medications, tests, and procedures<\/li>\n<li style=\"text-align: left;\">Referring and communicating with other health-care professionals<\/li>\n<li style=\"text-align: left;\">Documenting clinical information<\/li>\n<li style=\"text-align: left;\">Independently interpreting results<\/li>\n<li style=\"text-align: left;\">Communicating results to the patient, family, and\/or caregiver<\/li>\n<li style=\"text-align: left;\">Coordinating any other care<\/li>\n<\/ul>\n<p style=\"text-align: left;\">After getting informed regarding time definition, let\u2019s look at changes to medical decision-making criteria in detail<\/p>\n<p style=\"text-align: left;\">Codes <strong>99202-99215<\/strong> are associated with the medical decision-making elements consist of<\/p>\n<ul style=\"text-align: left;\">\n<li style=\"text-align: left;\">The number and complexity of problems addressed<\/li>\n<li style=\"text-align: left;\">The amount and\/or complexity of data to be reviewed and analyzed<\/li>\n<li style=\"text-align: left;\">Risk of complications and or morbidity or mortality of patient management<\/li>\n<\/ul>\n<p style=\"text-align: left;\">Out of the above three; two of the three elements must be met or exceeded to select a level of E&amp;M service.<\/p>\n<h3 style=\"text-align: left;\">New prolonged services code<\/h3>\n<p style=\"text-align: left;\">Last, a new code will be introduced to describe a 15-minute\u00a0<a href=\"https:\/\/practice.asco.org\/sites\/default\/files\/drupalfiles\/2020-06\/NewProlongedEM%20FINAL.pdf\">prolonged service<\/a>\u00a0with or without direct patient contact.<\/p>\n<p style=\"text-align: left;\">When the E&amp;M service has been selected based on time only (not medical decision making) and only after the total time of a level 5 service (either <strong>99205 or 99215<\/strong>) has been exceeded then It can only be reported.<\/p>\n<p style=\"text-align: left;\">Additionally, <strong>code 99201<\/strong> (new patient, level 1) will be deleted and it\u2019s rarely reported by oncologists, and therefore its deletion will have a relatively minimal impact on oncology practices. However, reportable service <strong>99211<\/strong> (established patient, level 1) is still in place.<\/p>\n<p style=\"text-align: left;\">Do you feel the revised E\/M updates will affect your reimbursement? Don\u2019t worry,<a href=\"https:\/\/www.medicalbillersandcoders.com\/speciality\/oncology-medical-billing-services.html\"> we are oncology billing and coding experts<\/a> and we help you to get your claims paid timely and efficiently.<\/p>\n<h2 style=\"text-align: left;\">FAQs:<\/h2>\n\n\n<div class=\"schema-faq wp-block-yoast-faq-block\"><div class=\"schema-faq-section\" id=\"faq-question-1757320567548\"><strong class=\"schema-faq-question\">1. What are the key changes to E\/M codes effective January 1, 2021?<\/strong> <p class=\"schema-faq-answer\">The coding system has been streamlined to focus on medical decision-making (MDM) rather than history and exam, allowing for more clinically intuitive coding.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1757320583916\"><strong class=\"schema-faq-question\">2. How does the definition of time impact E\/M coding?<\/strong> <p class=\"schema-faq-answer\">Total time spent on the date of the encounter now determines code selection, including activities like preparing for the visit, seeing the patient, and documenting information.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1757320596357\"><strong class=\"schema-faq-question\">3. What are the main elements of medical decision-making (MDM) in the new coding guidelines?<\/strong> <p class=\"schema-faq-answer\">MDM is assessed based on the number and complexity of problems addressed, the complexity of data reviewed, and the risk of complications in patient management.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1757320613227\"><strong class=\"schema-faq-question\">4. What is the new prolonged services code introduced with the updated E\/M guidelines?<\/strong> <p class=\"schema-faq-answer\">A new code will describe a 15-minute prolonged service, applicable only when total time for a level 5 service has been exceeded.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1757320626308\"><strong class=\"schema-faq-question\">5. How might these changes affect my practice\u2019s reimbursement?<\/strong> <p class=\"schema-faq-answer\">While some changes may initially seem daunting, our oncology billing and coding experts are here to help ensure your claims are processed efficiently and accurately.<\/p> <\/div> <\/div>\n","protected":false},"excerpt":{"rendered":"<p>It is important for all oncologists to be prepared as significant changes to the Evaluation and Management (E&amp;M) codes E\/M are into effect from January 1, 2021. Components for code selection were narrowed down to make them more clinically intuitive and to reduce variation among contractors and payers. Elements of MDM affecting coding for an [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":13063,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3],"tags":[120,737,738,2168,123,957,587],"class_list":["post-13057","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-oncology-billing-services","tag-cpt-code","tag-e-m-codes","tag-e-m-services","tag-evaluation-and-management","tag-medical-coding-services","tag-oncology-biling-services","tag-rcm-services"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.8 (Yoast SEO v27.8) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Oncologists should be prepared for E&amp;M service changes in 2021<\/title>\n<meta name=\"description\" content=\"In 2021, history and exam will no longer be used to select an E&amp;M service, but still must be performed in 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The main goal of our organization is to assist physicians looking for billers and coders, at the same time help billing specialists looking for jobs, reach the right place.\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/www.medicalbillersandcoders.com\\\/blog\\\/oncologists-should-be-prepared-for-em-service-changes-in-2021\\\/#faq-question-1757320567548\",\"position\":1,\"url\":\"https:\\\/\\\/www.medicalbillersandcoders.com\\\/blog\\\/oncologists-should-be-prepared-for-em-service-changes-in-2021\\\/#faq-question-1757320567548\",\"name\":\"1. What are the key changes to E\\\/M codes effective January 1, 2021?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"The coding system has been streamlined to focus on medical decision-making (MDM) rather than history and exam, allowing for more clinically intuitive coding.\",\"inLanguage\":\"en-US\"},\"inLanguage\":\"en-US\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/www.medicalbillersandcoders.com\\\/blog\\\/oncologists-should-be-prepared-for-em-service-changes-in-2021\\\/#faq-question-1757320583916\",\"position\":2,\"url\":\"https:\\\/\\\/www.medicalbillersandcoders.com\\\/blog\\\/oncologists-should-be-prepared-for-em-service-changes-in-2021\\\/#faq-question-1757320583916\",\"name\":\"2. How does the definition of time impact E\\\/M coding?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Total time spent on the date of the encounter now determines code selection, including activities like preparing for the visit, seeing the patient, and documenting information.\",\"inLanguage\":\"en-US\"},\"inLanguage\":\"en-US\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/www.medicalbillersandcoders.com\\\/blog\\\/oncologists-should-be-prepared-for-em-service-changes-in-2021\\\/#faq-question-1757320596357\",\"position\":3,\"url\":\"https:\\\/\\\/www.medicalbillersandcoders.com\\\/blog\\\/oncologists-should-be-prepared-for-em-service-changes-in-2021\\\/#faq-question-1757320596357\",\"name\":\"3. 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What is the new prolonged services code introduced with the updated E\\\/M guidelines?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"A new code will describe a 15-minute prolonged service, applicable only when total time for a level 5 service has been exceeded.\",\"inLanguage\":\"en-US\"},\"inLanguage\":\"en-US\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/www.medicalbillersandcoders.com\\\/blog\\\/oncologists-should-be-prepared-for-em-service-changes-in-2021\\\/#faq-question-1757320626308\",\"position\":5,\"url\":\"https:\\\/\\\/www.medicalbillersandcoders.com\\\/blog\\\/oncologists-should-be-prepared-for-em-service-changes-in-2021\\\/#faq-question-1757320626308\",\"name\":\"5. 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